Again on ageing as a disease: A rectification

My previous post was somewhat confusing even to myself. To be completely frank, I think it was a little bit of a fuck-up. Several people have commented about it, for example on Reddit or Facebook, pointing out among the rest that whether or not ageing is a disease isn’t just semantics and it isn’t pointless. (To the people commenting on Facebook, I’d like to say that I’m sorry I didn’t reply to your comments, but for some reason I was stuck as ‘Rejuvenaction’ on those posts, and Pages don’t seem to be allowed to comment on group posts. I tried to switch to my personal account to no avail. I figured out a workaround, but at this point it’s a bit too late.)

What I meant to say is that arguing whether or not ageing is a medical condition is far less important than treating its root causes, and as long as we focused on this task, we could postpone the debate to a later time. The finer points of establishing if ageing fits the definition of ‘disease’ to the letter would waste precious time we could spend saving lives instead; we should definitely not wait until the issue has been settled before we start developing rejuvenation biotechnologies. (And we are not waiting at all, luckily.) However, classifying ageing as a disease is very important and not at all pointless, as Reason of FA! explained in this post. In a nutshell, if the ageing processes that lead to age-related diseases were considered pathological, research on how to interfere with them would likely receive more funding, and drugs that target ageing itself could be approved by the FDA. (The FDA only approves drugs that target recognised diseases; if ageing isn’t recognised as one, no drugs targeting it would be approved.) I think there might be a chance that some bona-fide anti-ageing drugs would be approved even if ageing wasn’t recognised as a disease—for example, drugs that clear the amyloid plaques that build up in the brain would essentially be rejuvenation therapies preventing Alzheimer’s disease, and as such I suppose they would be approval material for the FDA, even if they did’t recognise ageing itself as a disease; nevertheless, it’s clear that things would be easier in terms of getting funding and approving drugs if the whole ageing process was classified as a disease.

That being said, if we want to decide if ageing is a disease, we really do need to have good definitions of both terms. It turns out that defining ‘disease’ is not a simple problem, and apparently WHO themselves don’t have an official definition. They do have a definition of health, though, which says among the rest that ‘ Health is […] not merely the absence of disease or infirmity’; the lack of an official WHO definition of disease makes their definition of health a bit problematic, in my opinion. I suppose they rely on the intuitive idea of ‘disease’ we all have, but as a mathematician, I find this decidedly insufficient. If you look up ‘disease’ on Wikipedia, you’ll find this:

A disease is a particular abnormal condition, a disorder of a structure or function, that affects part or all of an organism.

I don’t like this definition very much, because it might imply that a ‘normal’ condition isn’t a disease; however, the incidence of age-related disease grows higher and higher with age, to the point that I don’t see how they couldn’t be considered ‘normal’ past a certain age; that’s why I prefer a definition along the lines of ‘a definite pathological process having a characteristic set of signs and symptoms’.

As for the definition of ‘ageing’, I stick to Aubrey de Grey‘s definition, i.e. that ageing is the process of accumulation of damage the body inflicts itself as a side-effect of its normal operations. In the post we’re discussing, I said that even according to this definition, ageing wasn’t a disease, but only a cause of disease; I used a comparison I found very fit, i.e. that ageing is to age-related diseases what viruses are to infections. However, upon more careful reflection, this comparison is a bit misleading. It’s true that a virus is not a disease; however, a virus isn’t a process either, unlike ageing. A better comparison would be between age-related damage and viruses. The accumulation of damage could then be (rather loosely) compared to an infection, in the sense that both are processes that happen over time: They begin, they progress, and eventually give rise to symptoms and full-blown diseases.

Now, at least according to the second definition of ‘disease’ I provided, ageing seems to be one, because it is a pathological process (although an extraordinarily long one) that has a characteristic set of signs and symptoms. While symptoms and visible signs of ageing don’t show up until late in life, more subtle signs (accumulation of senescent cells, or cross-links, for example) are present inside your body basically at all times. The reason I call it a ‘pathological’ process is that the damage caused by ageing is, as said, a side-effect of your metabolism; it’s a bug, not a feature, left around by evolution because it was generally not serious enough to prevent you from reaching reproductive age. It’s a disease that stays silent until a certain threshold is reached—again, pretty much like an infection until there are enough viruses around to wreak havok.

Ultimately, ageing may or may not be a disease depending on the definition of ‘disease’ we want to adopt. With enough nitpicking, ageing may well not be a disease according to some definitions, but in principle we could change definitions around so much that Alzheimer’s disease stops being a disease and mountain climbing suddenly becomes one. (This is an intentionally ridiculous example.) I have no problem admitting that this is not what my previous post seemed to say, and I honestly have no idea how I managed to twist my own thoughts around so much that they ended up contradicting things I wrote before. I have a hunch I had grown a bit too fond of the metaphors I used in that post, which again seemed fitting but were confusing. I’m not a fan of revisionism, so my previous post is going to stay up right the way it is, just with a link to this one.

As a side note, some now-recognised age-related diseases were considered to be part of ‘normal’ ageing in the relatively recent past. Seems to me ‘normal’ is a safety-blanket word that we use to feel okay about not doing anything to change something that is not good and difficult to change. Or maybe, it’s just that we like feeling ‘normal’. If you’re 78 and your doctor says you’ve got high blood pressure, he’ll also probably reassure you and say that ‘at your age, it is normal’. So what? That only means that it’s common for a person of your age to have unhealthy blood pressure, and it’s in no way different from saying that it is normal for a smoker to have their lungs full of crap. It’s normal alright, but it is very bad nonetheless.

Here be DRACOs

This post isn’t about ageing, but about viral infections, which represent a health concern for just about anyone, regardless of their age. While “banal” viruses like the flu one are in general not too much of a hassle to deal with (at least if you’re young and with a healthy immune system), some others are much more pesky: HIV and Ebola, for example, can easily kill you or at least make your life a living hell, and at the moment there are no cures or vaccines available (although the recent outbreak of Ebola in Africa has to my knowledge resulted into the development of some potential vaccines which are currently under trial). The list of killer viruses is longer than that, and it’s not to be forgotten that, if your immune system is compromised, even a flu can turn into something much more serious and kill you.

The way we have dealt with viruses thus far is that of immune stimulation: vaccines are a preventative measure that basically make your immune system aware of the potential threat by means of introducing a killed or weakened form of the virus in your body. In this way, the virus cannot cause any harm (although sometimes you might get some watered-down symptoms), and your immune system can get to know the new pathogen, producing the appropriate immune cells to attack it, which will stick around an be ready to spring into action if needed.

Unfortunately this isn’t the bottom line. We’re not able to produce vaccines for all viruses: for example, HIV has been eluding our attempts for decades, despite the efforts put into the research and the progresses made (mostly in terms of antiretroviral drugs, since at the moment there is no fire-sure HIV vaccine). Viruses have evolution on their side, and they often evolve in such a way that our countermeasures become useless: that’s why, for example, there’s a new flu vaccine every year—the flu virus mutates fast.

There exist antiviral drugs, though, that instead of stimulating the immune system, try to inhibit the development of the virus directly—unlike most antibiotics, drugs targeted to bacteria and meant to kill them—but these drugs are difficult to develop, again because of the fast rate of mutations of viruses and because viruses use the host’s cells in their reproductive process: in a nutshell, it’s hard to interfere with viral replication without also harming the patient’s healthy cells. Additionally, for different viruses you need to design different drugs, so it’s kinda messy.

Some time ago, though, while working for Draper Laboratory, Dr. Todd Rider came up with a brilliant idea that promises to be the viral equivalent of antibiotics: DRACO.

DRACO (or rather DRACOs, since there are many) stands for Double-stranded RNA Activated Caspase Oligomerizer, and its working principle is very simple to explain in layman terms: all viruses use the host’s cells to reproduce. Once they’re done reproducing, the cell is almost certainly going to die, so it’s lost. The vast majority of  viruses, while reproducing, leaves behind a “trail” of double-stranded RNA, which is exactly what DRACO uses to screw the viruses over: DRACO doesn’t try to kill the virus, or to stimulate immune response. DRACO has two main components: one that targets the dsRNA trail, and one that triggers apoptosis, or programmed cell-death (your cells regularly do that, and then are replaced by new ones). You may guess already what happens at this point: DRACO detects infected cells by targeting the dsRNA trail, and when it finds it, it triggers apoptosis, killing the cell (which would be lost to the virus anyway) and preventing the virus from replicating.

DRACO is not just a theory: DRACO has been used in live mice and in human culture cells, and it has cleared them clean of 15 different dsRNA viruses, leaving healthy cells alone and without any adverse effect or sign of toxicity. Maybe it sounds too good to be true, but if you don’t belive me, believe the facts: have a look at Draper Laborary’s announcement a year ago, at the Wikipedia page of DRACO and the scientific paper published in 2011 by dr. Rider and his team. Just Google “DRACO antiviral” and have a look at the results. Or last but not least, check the video of a talk given by dr. Rider himself at—guess where—SRF’s conference SENS6 in 2013 (audio is unfortunately a bit crappy, bear with it).

Now, while it hasn’t yet been tested on live humans, there’s all the reasons to believe that DRACO would be just as effective as it has been in cells and mice, and that it would blow into the hell where they belong all those pesky little suckers obsessed with taking your life—including, but not limited to, HIV.

At this point you might think that, since the drug is so promising, they must be doing more experiments and that there’s funding going into them and that we’re soon to be told about human trials.

Unfortunately I can’t find the sources, but a while back I have read that the research funding coming from NIH (the National Institute for Health in the States) , which was the main (if not only) source of money for DRACO had either been cut or drastically reduced for some obscure reason.  A non-profit organization was thus put up by ordinary citizens, called The DRACO Fund, aiming to raise money to devolve to this particular research. A noble goal: according to dr. Rider, as little as 10 more years of research should be enough to make DRACO a commercially viable drug, putting an end to viral infections. Well, the organization existed since at least 2013, when their facebook page was created, but it didn’t last much longer past 2014: they received a legal order from Draper Laboratory asking them to shut the whole thing down, and saying that they had sufficient funding for research and they would thus no longer accept the donations that The DRACO Fund was collecting. Good if, as they said, they had enough funding to go on, but it’s hard to understand why would they send a cease and desist order to have The DRACO Fund shut down.
The website of The DRACO Fund no longer exists, and their facebook page, still online, is now called Killing sickness and it still supports DRACO, albeit my understanding is that they have been reduced down to a fan page, basically.

That’s not the whole story.
Some time ago I signed a petition (which I urge you to sign yourself, too) to push NIH and the White House to find funds for DRACO research, and recently I received an email update from the same petition. The update said that dr. Rider has left Draper Laboratory, and the news is as recent as May 29th, 2015. The author of the petition, Sabrina Montgomery, has been and still is struggling to find a new facility for dr. Rider to continue DRACO research and to get him the fundings that are needed.

I don’t know what’s going on behind the scenes, but I know that, given enough funding and attention from the general public and authorities, we could put a goddamn tombstone on HIV, Ebola, influenza, and a bunch of other viral diseases as soon as ten years from now. I understand that people prefer to share cat pictures and funny stuff on facebook, but perhaps it’s also the case to spread the word about something more important, too—something that one day might save your life or your dear ones’.

Bottom line: sign the petition, share it, tell your friends, and particularly if you live in the States, push your political representatives to do something about this. Get in touch with Sabrina Montgomery and see if you can help, if it’s possible to put up a larger organization to support DRACO, particularly now that Draper Laboratory doesn’t seem to be involved anymore and thus has no say on where funds come from.
Ten years from now we might be able to laugh in the face of HIV. Think about it.